Cognitive Dysfunction Syndrome in Dogs (CDS)
Cognitive dysfunction syndrome is a condition related to the aging of a dog’s brain, which ultimately leads to changes in awareness, deficits in learning and memory, and decreased responsiveness to stimuli. Although the initial symptoms of the disorder are mild, they gradually worsen over time, also known as “cognitive decline.” In fact, clinical signs of cognitive dysfunction syndrome are found in 50 percent of dogs over the age of 11, and by the age of 15, 68 percent of dogs display at least one sign.
Symptoms and Types
- Disorientation/confusion
- Anxiety/restlessness
- Extreme irritability
- Decreased desire to play
- Excessive licking
- Seeming disregard for previously learned training or house rules
- Slow to learn new tasks
- Inability to follow familiar routes
- Lack of self-grooming
- Fecal and urinary incontinence
- Loss of appetite (anorexia)
- Changes in sleep cycle (i.e., night waking, sleeping during the day)
Causes
Although the exact cause of cognitive dysfunction syndrome is currently unknown, genetic factors may predispose an animal to develop the condition.
Diagnosis
Note the onset and nature of the symptoms and possible incidents that might have precipitated the unusual behaviors or complications. We can then perform a complete physical examination to evaluate the overall health status and cognitive functions of the dog. Routine blood tests, ultrasounds, and X-rays are also employed to rule out other diseases that may lead to behavioral changes associated with cognitive dysfunction syndrome.
Treatment
Dogs with this cognitive dysfunction syndrome require life-long therapy and support. However, your help can make a world of difference when it comes to improving your dog’s cognitive functions. For example, although it will not “cure” your dog, maintaining a healthy and stimulating environment will help in slowing the progression of “cognitive decline.” This typically involves imposing a daily routine of exercise, play, and training.
In addition to medication and behavioral therapy, your veterinarian may suggest employing a special, balanced diet to improve the dog’s cognitive function; i.e., memory, learning ability, etc. This diet is also typically supplemented with antioxidants, vitamin E and C, selenium, flavonoids, beta carotene, carotenoids, Omega-3, and carnitine — all considered excellent for improving the dog’s cognitive functions.
There are commercially prepared diets to make this easy. Hill’s Prescription diet b/d and l/d. I will make a recommendation based on blood analysis.
ACUTE GENERAL TREATMENT
- Avoid exposure stimuli known to distress the animal.
- Early rewarding of any normal, preferred, or good interactive or elimination behaviors and encouraging normal locomotion
- There should be absolutely no punishment—physical, verbal, deprivational, or mental—for any undesirable behavior that occurs as a result of this condition. Such actions will render the patient more anxious.
- Protect the patient from attendant wanderings or odd behaviors while keeping it comfortable. The latter may involve containing it in an area with an absorbent surface when left alone.
- Mental stimulation in the early stages is important and may delay clinical progression. Treat balls, food toys, games involving puzzle solving, safe exercise, interactive tasks (“get the mouse,” “bring the ball,” etc.), and olfactory stimulation are useful.
CHRONIC TREATMENT
- As stated, plus physically and mentally stimulating exercises, such as swimming, massage, range of motion exercises.
- Encourage relaxation.
- If “loss of housetraining” occurs, ensure that the animal is taken out frequently to minimize the cost of “mistakes;” reward frequently as for a young pup and if needed diaper dog to decrease both client and dog distress.
- Encourage reestablishment of daily cycles by feeding at regular hours and at least a few hours before bedtime, and administer a benzodiazepine (alprazolam, clonazepam) before bed if needed.
- Protect the pet from accidents (e.g., falling into the swimming pool, falling down stairs).
- Specialized diets rich in antioxidants decrease the rate of cognitive dysfunction progression, improve behavioral function, and may have a protective effect (e.g., Hill’s B/D [Brain Diet]; Purina Veterinary Diets EN).
- In the United Kingdom, nutraceutical food additives are available and have been shown to improve function in dogs with cognitive changes (e.g., Aktivait, Vet Plus UK).
- Newer additives also are recommended as preventative agents (e.g., Senilife, CEVA; Novifit [SAM-e; Virbac]; omega-3 fatty acids [Nordic Naturals])
- The monoamine oxidase inhibitor, selegiline (Anipryl), 0.5 mg/kg PO q 24 h (may double dose after 1 month if ineffective) is the drug of choice and is licensed for use for the treatment of canine cognitive dysfunction in the United States.
Living and Management
We should evaluate your dog periodically to monitor its response to therapy and the progression of symptoms. However, if you notice any behavioral changes in the dog, notify me immediately. For stable patients, twice yearly checkups are sufficient enough, unless new problems arise.